Suicide among foreign-born minorities and native Swedes: An epidemiological follow-up study of a defined population

doi:10.1016/S0277-9536(96)00142-6

Social Science & Medicine

Volume 44, Issue 2, January 1997, Pages 181-187

https://doi.org/10.1016/S0277-9536(96)00142-6 Get rights and content

Abstract

The increasing number of immigrants in Sweden during the past four decades has brought the health of ethnic groups into focus. The purpose of this study was to analyse the influence of ethnicity, age, sex, marital status and date of immigration on suicide rates. The study population consisted of all individuals over 15 years of age, N = 6,725,274, from the Swedish census of 1985 and is based on individual data. Suicides and undetermined deaths, during the follow-up period 1986–1989, were taken from the central Cause of Death Register. Ethnicity, defined as being foreign-born, was a risk factor for suicide for both men and women with risk ratios of 1.21 (1.11–1.31) and 1.36 (1.21–1.53), respectively, with control for age and marital status. Being unmarried was also a risk factor for both males and females with risk ratios from 1.26 to 5.55 in different age groups. The highest risk ratios for suicide in Sweden, adjusted for age, were found among males born in Russia and Finland. They also showed higher suicide risks than in their countries of birth. Females born in Hungary, Russia, Finland and Poland all had high risks of committing suicide in Sweden, and they also had higher risks than in their countries of birth. Further, being of male sex, aged 45–54 or 75 and older, and born in Eastern Europe or Finland were significant risk factors for suicide. The same was true for those who had immigrated to Sweden in 1967 or earlier and were born in Finland, Eastern Europe or in non-European countries. These findings are of great importance for primary health care and psychiatric care planning.

References (17)

A. Antonovsky
Unravelling the Mystery of Health
(1987)
P.W. Burvill
Suicide during 1961–1970 of migrants in Australia
Psychol. Med.
(1982)
R. Chandrasena et al.
Suicide among immigrant psychiatric patients in Canada
Br. J. Psychiatr.
(1991)
M. Ferrada-Noli et al.
Definite and undetermined forensic diagnoses of suicide among immigrants in Sweden
Acta Psychiatr. Scand.
(1995)
E.V. Kliewer et al.
Convergence of suicide rates to those in the destination country
Am. J. Epidemiol.
(1988)
G.G. Koch et al.
Poisson regression
M.G. Marmot et al.
Immigrant Mortality in England and Wales 1970–1978
(1984)
M. Monk
Epidemiology of suicide
Epidemiol. Rev.
(1987)

There are more references available in the full text version of this article.

Cited by (76)

Socio-economic status and risk for suicide by immigration background in Norway: A register-based national study
2018, Journal of Psychiatric Research
Citation Excerpt :
However, knowledge on the relative importance of socio-economic factors with respect to risk for suicidal behaviour in the immigrant population is relatively lacking. The few studies having examined the impact of these factors on suicide among immigrants have identified unemployment, unmarried status and low social integration as risk factors (Bayard-Burfield et al., 1999; Duldulao et al., 2009; Johansson et al., 1997; Kposowa et al., 2008; Tinghög et al., 2007). Low educational levels have also been shown to increase the risk of attempting suicide in young immigrants (van Bergen et al., 2010).
The relative importance of socio-economic factors on risk for suicide in the immigrant population may differ from that for the native population; however, few studies have addressed this issue on a national basis. With a nested case-control design and data from Norwegian population registers we identified 11,409 suicide cases in the years 1992–2012 and 191,785 sex-birthdate-matched controls. The influence of socio-economic factors on the risk for completed suicide was assessed through conditional logistic regression. Among 11,409 suicides, 1139 (10%) were individuals with an immigration background of either themselves or their parent(s). Suicide cases, as well as the controls, with an immigration background differed in several aspects of their socio-economic status from those without such a background. Being single or separated, divorced or widowed, was, however, associated with an increased risk of suicide regardless to the subjects’ immigration background. Low level of education and low annual income significantly increased the risk for suicide in almost all the study subgroups. Living in the capital area was associated with a reduced risk of suicide in first-generation immigrants but an increased risk in native Norwegians. In conclusion, persons with an immigration background, as well as native Norwegians, shared most common risk factors for suicide, but the strength of associations between socio-economic factors and risk for suicide can differ by immigration background.
Symptoms, comorbidity, and clinical course of depression in immigrants: Putting psychopathology in context
2013, Journal of Affective Disorders
Citation Excerpt :
In North America, the ‘healthy immigrant effect′ – the finding that recent immigrants are in better health than the native population – has been widely reported for mental (Aglipay et al., 2012; Alegria et al., 2008; Burnam et al., 1987; Grant et al., 2004; Menezes et al., 2011; Stafford et al., 2011) as well as somatic health (Ali et al., 2004; Gushulak, 2007; Hyman, 2004; Ng, 2011; Singh and Hiatt, 2006). In contrast, European studies reported a higher prevalence of mental disorders in migrant populations (Bayard-Burfield et al., 2001; Ferrada-Noli, 1997; Johansson et al., 1997, 1998; Levecque et al., 2007; Missinne and Bracke, 2010; Norredam et al., 2009; Sundquist, 1994; Tinghög et al., 2007); similar results for specific subgroups of migrants were found in North America (Alegria et al., 2008; Cislo et al., 2010; Fenta et al., 2004; Oquendo et al., 2004). Recently, the Canadian Guidelines for Immigrant Health (Kirmayer et al., 2011) concluded that migration should be considered as a risk factor for depression (and probably other mental disorders) when it is associated with experiences of adversity.
Migration is considered a depression risk factor when associated with psychosocial adversity, but its impact on depression's clinical characteristics has not been specifically studied. We compared 85 migrants to 34 controls, examining depression's severity, symptomatology, comorbidity profile and clinical course.
A MINI interview modified to assess course characteristics was used to assign DSM-IV axis I diagnoses; medical files were used for Somatoform Disorders. Severity was assessed with the Montgomery-Asberg scale. Wherever possible, we adjusted comparisons for age and gender using logistic and linear regressions.
Depression in migrants was characterized by higher comorbidity (mostly somatoform and anxiety disorders), higher severity, and a non-recurrent, chronic course.
Our sample comes from a single center, and should be replicated in other health care facilities and other countries. Somatoform disorder diagnoses were solely based on file-content.
Depression in migrants presented as a complex, chronic clinical picture. Most of our migrant patients experienced significant psychosocial adversity before and after migration: beyond cultural issues, our results suggest that psychosocial adversity impacts on the clinical expression of depression. Our study also suggests that migration associated with psychosocial adversity might play a specific etiological role, resulting in a distinct clinical picture, questioning the DSM-IV unitarian model of depression. The chronic course might indicate a resistance to standard therapeutic regimen and hints at the necessity of developing specific treatment strategies, adapted to the individual patients and their specific context.
Is it Better to Intermarry? Immigration Background of Married Couples and Suicide Risk Among Native-Born and Migrant Persons in Sweden
2023, European Journal of Population
Substance use, affective symptoms, and suicidal ideation among Russian, Somali, and Kurdish migrants in Finland
2022, Transcultural Psychiatry
Unmet Need for Mental Healthcare in a Population Sample in Sweden: A Cross-Sectional Study of Inequalities Based on Gender, Education, and Country of Birth
2021, Community Mental Health Journal
Sociodemographic and gender determinants of late-life suicide in users and non-users of antidepressants
2020, European Journal of Public Health

View all citing articles on Scopus

View full text

Suicide among foreign-born minorities and native Swedes: An epidemiological follow-up study of a defined population

Abstract

Unravelling the Mystery of Health

Suicide during 1961–1970 of migrants in Australia

Psychol. Med.

Suicide among immigrant psychiatric patients in Canada

Br. J. Psychiatr.

Definite and undetermined forensic diagnoses of suicide among immigrants in Sweden

Acta Psychiatr. Scand.

Convergence of suicide rates to those in the destination country

Am. J. Epidemiol.

Poisson regression

Immigrant Mortality in England and Wales 1970–1978

Epidemiology of suicide

Epidemiol. Rev.